Sunday, June 16, 2013

One, two, three

They all came so early. In the states they would have been in a
critical time frame, but here we don’t consider it such. They always just die. It isn't as critical when there is truly nothing else that you can do to help. The developing world limits you in ways that training never really prepared you for. But three of them came within the same week or two. They demanded our attentions.
Twenty-six week premature babies.

The first was likely a complication of her
mother’s sickness. Mom had been hospitalized earlier in pregnancy at an outside
facility and taken to surgery for an unknown indication. She had a
complication, and ended up at our hospital for corrective surgery. So two
surgeries later, and a big open wound on her belly, she was stuck here for a while. One morning weeks later I was told casually that the pregnant woman was having some
pain. When I laid my eyes on her, I knew she wasn’t just having a bit of pain,
she was about to deliver. No time for anything else, just move toward the
delivery room. Out came the baby, tiny and frail, but breathing and doing
pretty well. I realized that the situation was grim, but dared to hope.

Within two weeks, two more babies joined her in the make-shift
NICU. There is really nothing there except some special tubing to blow air into
the babies little noses and mouths. They were all fighting hard. Each time the
power would go off (many, many times a day), the oxygen would also go off.
Then, the cover over the mouth and nose becomes more of a suffocation device,
instead of an oxygen providing device. The pediatricians and I would catch our
breath, realizing that at that moment it was getting more difficult for the
babies to catch theirs. The nurses were instructed to remove the devices if the
power stopped, but sometimes it took a bit too long for them to get around to
it.

That was only one of the obstacles. One morning ants were found to
have crawled into the baby warmer, and were biting one of the baby’s legs. Feedings
through the small plastic tubes attached to the little faces were commonly
forgotten, sometimes for an entire shift. Though addressed over and over, it
was an all too frequent occurrence. Other things, common for such premies
started to happen as well. Eating became more difficult. Bellies would swell,
so food would have to be stopped temporarily to try to remedy the situation.

The first one to die was the most at risk. The baby had been
exposed to infection inside, both from the water bag around it breaking too
early, and from the mom’s HIV infection. It fought for a while, but then succumbed.
Next came the one that seemed to have the most opportunity. It had gotten some
medicines while still inside mom that usually help some. But it too suddenly
turned the corner, began seizing, and then died. But the first, tiniest, least
likely baby was still holding on. We all began to hope a bit more. She had
lived for over a month, with minimal intervention available to aid her. A neonatologist
came to visit from the states and took over her care. We all breathed a bit
easier, knowing now there was a specialist who could maybe know just a bit
better something to help her to make it through. It started to look up. She was
holding steady. But then she began to have difficulty breathing. There was nothing left for the pediatricians or neonatologist to do. Within the
night, she died as well.

We all knew the whole time that medically it was very, very unlikely that any of
these babies would live. But, we dared to dream that at least one might make
it. We knew it would be against all odds, but we prayed and hoped. Turns out
that wasn’t what the Creator had in mind. And if He can make and fashion and
weave all that makes up a human inside the unseen world of the mother’s tummy,
He can be trusted to do what is right with what He has made. So many things in
this life are beyond what we can understand, but we trust, knowing that God does
understand. He is infinitely more good than we can imagine, even when circumstances aren't looking good to our eyes. I am so glad that
He allows us to know Him, so that we can then trust Him even when we cannot see
the plan.

Praise the Lord for creating, and providing, and giving, and taking away. He alone is big enough to hold it all together, beyond anything we could imagine.